Adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia: Systematic review and meta-analysis.

Demeke Mesfin Belay,Wubet Alebachew Bayih,Demewoz Kefale Mekonen,Wasihun Hailemichael Belayneh,Amare Simegn Ayele,Biniam Minuye Birihane,Abebaw Yeshambel Alemu,Aklilu Endalamaw Sinshaw,Henoke Andualem Tegared,Frank T Spradley

doi:10.1371/journal.pone.0241811

Demeke Mesfin Belay, Wubet Alebachew Bayih + Show 8 more

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https://doi.org/10.1371/journal.pone.0241811

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Journal: PloS one	Publication Date: Nov 10, 2020
Citations: 9	License type: CC BY 4.0

Affiliation: Debre Tabor University, Bahir Dar University

Abstract

The magnitude of adverse birth outcome among diabetic pregnant women is high in low-and-middle income countries, like Ethiopia. Precise epidemiological evidence is necessary to plan, evaluate and improve effective preventive measures. This systematic review and meta-analysis is the first to estimate the pooled prevalence of adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia. PubMed, Cochrane Library, Google Scholar, SCOPUS, Web of Science and PsycINFO, and article found in University online repository were accessed. Observational studies such as cross-sectional, case-control and prospective cohort reported using English language was involved. I2 statistic was used to check heterogeneity. Egger's test and funnel plot were used to measure publication bias. Weighted inverse variance random effects model was also performed. Seven studies with 1,225 study participants were retrieved to estimate the pooled prevalence of adverse birth outcome and associated factors. The pooled prevalence of adverse birth outcome among diabetic pregnant women was 5.3% [95% CI; 1.61, 17.41]. Fasting blood glucose level above 100 mg/dl [Adjusted Odds ratio (AOR) = 10.51; 95% Confidence Interval (CI) = 5.90, 15.12], two hour post prandial glucose level above 120 mg/dl [AOR = 8.77; 95% CI = 4.51, 13.03], gestational age <37 completed week [AOR = 9.76; 95% CI = 5.29, 14.23], no ANC follow-up [AOR = 10.78; 95% CI = 6.12, 15.44], history of previous adverse outcomes [AOR = 3.47; 95% CI = 1.04, 5.90], maternal age < 30 years [AOR = 3.47; 95% CI = 1.04, 5.90], and illiteracy [AOR = 2.89; 95% CI = 0.81,4.97)] were associated factors of adverse birth outcome. The pooled prevalence of adverse birth outcomes among diabetic pregnant women in Ethiopia was high. Child born from mothers who were illiterate, maternal age < 30 years, gestational age < 37 completed weeks, history of previous adverse birth outcomes and no ANC follow-up increased the risk of adverse birth outcome. It is registered in PROSPERO data base: (PROSPERO 2020: CRD42020167734).

Highlights

Diabetes Mellitus (DM) is a group of metabolic disorders characterized by a high blood sugar level over a prolonged period of time and caused by either from deficiency in insulin secretion, decreased insulin action or both [1]
Fasting blood glucose level above 100 mg/dl [Adjusted Odds ratio (AOR) = 10.51; 95% Confidence Interval (CI) = 5.90, 15.12], two hour post prandial glucose level above 120 mg/dl [AOR = 8.77; 95% CI = 4.51, 13.03], gestational age
Child born from mothers who were illiterate, maternal age < 30 years, gestational age < 37 completed weeks, history of previous adverse birth outcomes and no ANC follow-up increased the risk of adverse birth outcome

Summary

Introduction

Diabetes Mellitus (DM) is a group of metabolic disorders characterized by a high blood sugar level over a prolonged period of time and caused by either from deficiency in insulin secretion, decreased insulin action or both [1]. Along with other form of DM; child-bearing women are at a higher risk of developing DM in pregnancy [1, 2]. This result in hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or gestational diabetes which increased the risks of adverse birth outcomes [3]. A woman with hyperglycemic pregnancy have higher chance of developing adverse birth outcomes, like congenital anomaly, prematurity, still birth, macrosomia, neonatal hypoglycemia and spontaneous abortion, regardless of major improvement in clinical management [7,8,9]. The magnitude of adverse birth outcome among diabetic pregnant women is high in lowand-middle income countries, like Ethiopia.

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